Date Confirmation Special Enrollment Period: COVID-19
Explanation: Although a Special Enrollment Period (SEP) was confirmed by CMS on May 5, 2020, further clarification was needed regarding the end date.
We are pleased to announce that CMS has confirmed the time frame for the COVID-19 SEP.
Confirmed Time Frame:
Effective immediately, individuals meeting the requirements listed in the original COVID-19 SEP announcement (link below) can enroll, dis-enroll, or switch MAPD plans until June 30, 2020.
If CMS issues guidance to extend this SEP, updates will be provided.
COVID-19 SEP Announcement:
As promised, we continue to closely monitor the COVID-19 pandemic and are working hard to keep you informed. On May 5th, CMS clarified that the exceptional conditions Special Enrollment Period (SEP) for Individuals Affected by a FEMA-Declared Weather Related Emergency or Major Disaster is applicable and is available for beneficiaries who were eligible for — but unable to make — an election because they were affected by the COVID-19 pandemic. Please reference the following guidelines for the incident period. This SEP applies to all 50 states, tribes, territories, and the District of Columbia.
Who is Eligible:
Centers for Medicare & Medicaid Services (CMS) has advised Medicare Advantage (MA) and Part D plan sponsors that the exceptional conditions Special Enrollment Period (SEP) adopted under 42 CFR 422.62(b)(4) and 423.38(c)(8)(ii) for Individuals Affected by a FEMA-Declared Weather Related Emergency or Major Disaster is applicable and is available for beneficiaries who were eligible for — but unable to make — an election because they were affected by the COVID-19 pandemic and meet the terms of the SEP listed below.
This SEP opportunity will be available to beneficiaries who:
Reside, or resided at the start of the incident period, in an area for which FEMA has declared an emergency or a major disaster and has designated affected counties as being eligible to apply for individual or public level assistance;
Had another valid election period at the time of the incident period, and;
Did not make an election during their other valid election period.
Impacted Areas: All 50 states, tribes, territories, and the District of Columbia
Timeframe: Effective immediately, A SEP exists for individuals affected by a weather-related emergency or major disaster who were unable to and did not make an election during another valid election period during such as OEP or as a result of the emergency or major disaster. This includes both enrollment and disenrollment elections. Further, an eligible beneficiary would be given one opportunity to make that missed election as a result of this SEP. Beneficiaries will not be expected to provide proof that they were affected by the pandemic-related emergency.
*Note: Eligible enrollments will be effective the first of the month after the application has been processed.
Agents can accept/submit an application by the beneficiary’s request through the following steps:
Obtain a compliant Consent to Contact (C2C).
Capture a compliant Scope of Appointment (SOA).
Host a compliant 1:1 appointment.
If the beneficiary is prepared to enroll, complete an application noting this SEP
Enrollment Period Selection:
When enrolling your client for a weather related emergency or major disaster SEP within the Ascend online application you must make sure to use the correct election selection in the election period section of the application.
The election you need to choose is: “I was affected by a weather-related emergency or major disaster as declared by the Federal Emergency Management Agency (FEMA). One of the other statements here applied to me, but I was unable to make my enrollment because of the natural disaster.”
CMS will continue to monitor the circumstances in the affected areas and, if necessary, will consider taking additional action. Please click here for continued updates on affected areas through the FEMA website.
Approval ID: SCApproved-343-EFT-20200506
For Agent use only – Not approved for presentation or distribution to Medicare beneficiaries